The District Health Officers (DHOs) want their salaries increased from the current Shs4.6M to Shs15M per month if the country is to get DHOs to oversee management of health services in the districts across the country.
The call was made by David Ivan Kamya, Chairperson of Association of District Health Officers in Uganda, while appearing before Parliament’s Health Committee to discuss their working environment.
“The people you have here are actually working like missionaries; we are dedicated to work for the country …. the salary of DHOs must be increased to Shs15M and you will find the whole country has DHOs who are willing to offer services,” said Kamya.
According to Kamya, most of the districts in Uganda don’t have substantive DHOs, with many opting for private donor projects because of the meager pay and the salary increment will attract them back to the system.
Patrick Onzuba, DHO Maracha district wondered why DHOs are only paid Shs4.6m yet medical consultants with the same job specifications are paid Shs11M.
He said Salary enhancement for DHOs has been lower than that for health professionals with similar job specifications.
Onzuba also wondered why the Ministry of Health chose to start implementation of the new human resource restructuring at national level, instead of district level, stations that are closer to service delivery.
The Association also blamed National Medical Stores (NMS) for failing to deliver enough medical equipment, citing Maracha districts where some health facilities receive 30 Mama Kits yet such facilities have about 50 mothers giving birth daily, but DHOs take the heat for stealing medicine.
“In facilities that deliver 50 mothers a month, they deliver 30 (mama kits), so mothers who come later, they find they have run out. Several politicians campaign in the name of arresting drug thieves, but you end up getting none. If we speak the same language, we should be able to reduce lust for medicine,” said Onzuba.
Florence Nebanda (DWR Butaleja) welcomed the proposal to increase salaries of DHOs because most of the health workers undergo a hefty training which is expensive, yet they are paid as scientists.
Yusuf Nsibambi, the MP for Mawogola South called for streamlining on governance issues among DHOs and clarify on which officers they should report to, citing an example in Mpigi where he attends meetings with DHOs with different officers like Chief Administrative Officers, District Security Officers and LCVs, leaving them with no time to supervise medical facilities.
He also wondered how the DHOs supervise herbalists and the many mushrooming health facilities and also whether the DHOs had an input in the decision for Government to ban local birth attendants.
“There is confusion on where you report because CAO, DISO, LCV. You find DHO seated there in the meeting entire day yet they are supposed to be supervising health facilities. There are so many mushrooming clinics, herbalists, how do you do approval, licensing and supervision of these units? What is your take on the abolition of health center IIs yet they are the closest health units to the people?” asked Nsibambi.
The Chairperson Health Committee, Charles Ayume called for an end to the creation of new districts to allow Government establish new health facilities, saying the appetite for new districts hasn’t been matched with speed to establish health facilities.
He said that currently, it costs about Shs30Bn to create a basic health facility and this doesn’t include the cost to hire and maintain 200 personnel to run these facilities.
Ayume also decried the corruption in district health service commission, saying most LCVs are fond of hiring incompetent people or gift the medical posts with their girlfriends, to the detriment of service provision.
In March 2019, Minister of Health, Jane Aceng tabled before Parliament a report on the state of the health service delivery in Uganda, where she revealed that a total of 39 districts do not have any hospitals at all.
Among the districts cited included; Alebtong, Amuria, Amuru, Bukedea, Bukomansimbi, Bulambuli, Buvuma, Buyende, Dokolo, Gomba, lsingiro, Kalangala, Kaliro, Kamwenge, Kibuku, Koboko, Kole, Kotido, Kween and Kyankwanzi.
The other districts without hospitals are; Kyegegwa, Luuka, Lamwo, Lwengo, Manafwa, Mitoma, Nakapiripirit, Namutumba, Namayingo, Ntoroko, Otuke, Pader, Rubirizi, Serere, Sironko, Kibale, Kakumiro, Rubanda and Omoro.
The Minister said that the population of most of these districts does not meet the recommended catchment population for a general hospital except Isingiro, Amuria and Serere districts.
According to the National Health Policy, a general hospital serves a population of 500,000 and at the moment, there are 147 hospitals of which 63 are government, 64 NGO and 20 are private.